CA2898554A1 - Endoscope, particularly for minimally invasive surgery - Google Patents
Endoscope, particularly for minimally invasive surgery Download PDFInfo
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- CA2898554A1 CA2898554A1 CA2898554A CA2898554A CA2898554A1 CA 2898554 A1 CA2898554 A1 CA 2898554A1 CA 2898554 A CA2898554 A CA 2898554A CA 2898554 A CA2898554 A CA 2898554A CA 2898554 A1 CA2898554 A1 CA 2898554A1
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- endoscope
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00193—Optical arrangements adapted for stereoscopic vision
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00174—Optical arrangements characterised by the viewing angles
- A61B1/00177—Optical arrangements characterised by the viewing angles for 90 degrees side-viewing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00194—Optical arrangements adapted for three-dimensional imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/0605—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements for spatially modulated illumination
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computerised tomographs
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
- G01B11/00—Measuring arrangements characterised by the use of optical techniques
- G01B11/24—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures
- G01B11/25—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures by projecting a pattern, e.g. one or more lines, moiré fringes on the object
- G01B11/2513—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures by projecting a pattern, e.g. one or more lines, moiré fringes on the object with several lines being projected in more than one direction, e.g. grids, patterns
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- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2407—Optical details
- G02B23/2415—Stereoscopic endoscopes
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2407—Optical details
- G02B23/2461—Illumination
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
- A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
Abstract
Three-dimensional detection of an interior space of a body is performed by an endoscope in which a projection device projects a color pattern onto a region of the interior space and a detecting device detects an image of the color pattern projected onto the region. The projection and detection devices are positioned at least in part in a distal end region of an elongate endoscope extent. The distal end region can be angled up to 180° in relation to the original elongate endoscope extent. Active triangulation can be used in evaluating 3D images of the region to simply and effectively enlarge the 3D images. Such endoscopes can be used particularly advantageously in minimally invasive surgery or in industrial endoscopy.
Description
CA 02898554 2015-07-17 , A.
Description Endoscope, particularly for minimally invasive surgery The invention relates to an endoscope, particularly for minimally invasive surgery, according to the preamble of the main claim.
In comparison with frequently conventional open surgery, numerous methodological-technical restrictions apply to minimally invasive or laparoscopic and in particular scarless surgery. Said restrictions relate primarily to visualization, spatial orientation, assessment of the tissue constitution and the spatial confinement of the work area with greatly reduced degrees of freedom. For this reason, complex interventions, in particular, have hitherto not yet been able to be carried out minimally invasively, even though this would be inherently very desirable.
Therefore, intensive research and development efforts are being made globally in order to extend the applicability of minimally invasive surgery.
One major disadvantage of conventional minimally invasive surgery is missing or inaccurate information about the third dimension, since only the organ surfaces are viewed and, for example, the sense of touch cannot be used to localize a tumor internally in an organ. The depth information could be conveyed, in principle, by the projection of volume data sets obtained preoperatively, but this form of augmented or enhanced reality conventionally fails for lack of reliable referencing.
In comparison with preoperative diagnostics, intraoperatively a more or less pronounced position and shape change, for example of an intra-abdominal anatomy, can always occur, to which a preoperative data set has to be adapted in each case. Such an POT/EP2013/075042 - ld -adaptation would be possible in terms of software if, in comparison CA 02898554 2015-07-17 , with the prior art, more exact information were available about a current surface of an organ for example in an abdominal space. In addition, conventionally a field of view is greatly restricted.
Numerous approaches propose a precise, continuous depth measurement in real time. Conventionally, it is not possible to determine accurate distances between a respective anatomy and the measurement objects used at every point in time of an intervention. The absence of this information is a cause of a large number of problems that currently still exist.
For the further development of medical operations via natural orifices of the body, a precise 3D metrology is the key technology. Without a successful implementation, NOTES (Natural Orifice Transluminal Endoscopic Surgery), or the minimally invasive surgery without scars, which involves operating by means of access through natural orifices of the body, will not be able to be introduced into clinical care. The use of mechatronic auxiliary systems is essential for NOTES. Said systems in turn necessarily require a reliably functioning depth or 3D metrology for collision avoidance, for the compensation of breathing- or respiration-dictated organ deflections and a large number of further functions.
Various solution approaches used hitherto in other technical fields can be used to provide 3D information and corresponding 3D metrology.
Stereoscopy Stereoscopic triangulation is a conventional principle of distance measurement. In this case, an object is imaged from two observation directions by means of cameras. If a distinctive point is recognized in both recordings, then CA 02898554 2015-07-17 , given a known distance between the cameras, the so-called base, a triangle is spanned which is uniquely determined with the base value and two angles and enables the distance of the point to be calculated. What is usually disadvantageous here, however, is the fact that there are too few distinctive points in the object and too few corresponding points are thus found in the cameras. Such a problem is referred to as the correspondence problem.
Phase triangulation In order to avoid such a correspondence problem, so-called active triangulation has conventionally been used, which projects from one direction known patterns or, as in the case of phase triangulation, a sequence of sinusoidal patterns onto an object. As a result of the imaging of the object from another direction, the pattern appears distorted depending on the shape of the pattern surface, wherein the three-dimensional surface can in turn be calculated from this distortion, which is likewise referred to as a phase shift. This procedure enables even totally contrastless and markerless surfaces to be measured. What is disadvantageous about this type of 3D
measurement in the field of minimally invasive surgery is an only minimal space for accommodating a camera and a projector -fitted at an angle - for projecting pattern sequences. A
further disadvantage is that the position with respect to the object must not be altered during a projection sequence, since otherwise the 3D coordinate calculation is greatly beset by errors.
Time of flight The disadvantage of the 3D coordinate calculation beset by errors on account of an object movement likewise occurs in the so-called time of flight (TOF) methods. Here, likewise, from a CA 02898554 2015-07-17 , PCT/E22013/075042 - 3a -location of the object surface, at least four intensity values are measured for different times of flight of an intensity-modulated transmission signal. A computation of these , 2013P01205WOUS
intensity values produces a respective distance value. A
further challenge however is in particular the measurement of the time-of-flight differences caused by distance differences in the millimeters range given the very high speed of light in the region of 300 000 km per second. Conventional systems can measure the distance of a single object point at a resolution of one millimeter by using highly developed detectors and electronics. Only inadequate values for surgery in the centimeters range are achieved for planar TOF distance sensors.
Structure from motion This method is based on the fact that, in principle, by means of the motion of a camera in front of an object, many images are recorded from different directions and triangulation is made possible again, in principle, in this way. However, the so-called correspondence problem arises again in this case, that is to say that a distinctive point has to be recognized in the respective sequential images. Furthermore, it is not possible to calculate absolute, but rather only relative values, since the triangulation base, the distance and the orientation between the temporal recordings are not known or would additionally have to be measured by tracking systems.
The problem addressed by the present invention is that of providing an endoscope such that a visualization, a spatial orientation and/or an assessment of an object, in particular of tissue, in particular in the case of a spatial confinement of a work volume with reduced degrees of freedom, are/is improved and simplified in comparison with conventional systems. In particular, an applicability to minimally invasive surgery is intended to be extended. Complex minimally invasive interventions are likewise intended to be implementable. A
precise, continuous depth measurement in real time is intended to be made possible and accurate distances between endoscope and object are intended to be determinable at every point in PC1/EP2013/075042 - 4a time of an intervention. An , 2013P01205WOUS
endoscopic apparatus is intended to be provided such that 3D
measurement data of surfaces, in particular in the field of minimally invasive surgery, are generated with a higher data quality in comparison with the prior art.
For the integration of optical systems particularly in the field of minimally invasive surgery (MIC), it is important that the optical systems are sufficiently miniaturizable and nevertheless do not lose their performance in the sense of imaging or measurement accuracy. It is necessary to overcome the disadvantage that a reduction of dimensions in an optical system generally likewise means a loss of information transmission capacity, be it that the size of a field of view is reduced or that the resolution capability is reduced. This concerns 3D metrology, in particular since the latter has to likewise transmit the third dimension.
The problem is solved by means of an endoscope as claimed in the main claim.
In accordance with one aspect, an endoscope for three-dimensionally detecting a region of an internal space is proposed, wherein the endoscope extends along an original elongate endoscope extent as a longitudinal body having a distal end region which can be angled by up to 1800, in parti-cular up to 1100 or 90 , with respect to the original elongate endoscope extent, wherein an apparatus for three-dimensionally detecting the region by means of active triangulation is formed at least partly in the distal end region.
The three-dimensionally measuring optical system proposed makes it possible to produce measurements of distance to individual points of a surface of an internal space and more exact information about an internal space of a body. An endoscopic apparatus is proposed which, particularly for minimally invasive surgery, provides three-dimensional measurement data PCT/EP2013/075042 - 5a -, 2013P01205W0US
of surfaces with higher data quality in comparison with CA 02898554 2015-07-17 , the prior art. Conventional so-called active triangulation is particularly advantageously used, which projects from one direction known patterns or, as in the case of phase triangulation, a sequence of sinusoidal patterns onto an object. Configurations such as are known from DE 10 232 690 Al are particularly advantageous.
Further advantageous configurations are claimed in association with the dependent claims.
In accordance with one advantageous configuration, the apparatus for three-dimensionally detecting the region can have a projection device for projecting an, in particular redundantly coded, color pattern onto the region and a detection device for detecting an image of the color pattern projected onto the region.
In accordance with a further advantageous configuration, a transmission device can be designed for transmitting the image generated by the detection device to an evaluation device for processing the image to form three-dimensional object coordinates which can be represented as a 3D image for an operator by means of a display device.
In accordance with a further advantageous configuration, the projection device and/or the detection device can be formed at least partly in the distal end region.
In accordance with a further advantageous configuration, the projection device and the detection device can be formed completely or one of the two can be formed completely and the other is formed partly in the distal end region in such a way that both have in each case a viewing direction substantially perpendicular to the elongate extent of the angled distal end region.
In accordance with a further advantageous configuration, the two viewing directions can be rotatable about a rotation axis running along the elongate extent of the distal end region, in particular an axis of symmetry of the distal end region. A
restricted field of view can be extended in this way since, by means of a depth map, a large number of individual images of the internal space can be joined together to form a virtual panorama, which can likewise be referred to as "mosaicing" or "stitching". Such an extension of the field of view can considerably facilitate performance of an operation, for example, and effectively improve a safety level.
In accordance with a further advantageous configuration, either the projection device or the detection device can be formed completely and the other is not formed in the distal end region and both can have substantially parallel viewing directions in an angled state.
In accordance with a further advantageous configuration, the two viewing directions substantially can run along the original elongate endoscope extent.
In accordance with a further advantageous configuration, it is possible that the endoscope can be angled by approximately 900 with respect to the regional elongate endoscope extent.
In accordance with a further advantageous configuration, a portion of the projection device and of the detection device which is not formed in the distal end region can be formed in the longitudinal body adjoining the distal end region.
In accordance with a further advantageous configuration, a portion of the projection device and of the detection device which is not formed in the distal end region can be formed outside the longitudinal body at a side of a proximal end region of the longitudinal body.
PCT/EP2013/075042 - a -In accordance with a further advantageous configuration, the detection device or the projection device can be formed outside the longitudinal body and the other is formed in the distal end region.
In accordance with a further advantageous configuration, proceeding from the detection device or projection device formed outside the longitudinal body, an image guide device can be formed into the longitudinal body to an objective adjoining the distal end region in the distal end region.
In accordance with a further advantageous configuration, if the projection device is formed in the distal end region, a light guide device to the projection device can be formed from a light source outside the longitudinal body into the longitudinal body.
In accordance with a further advantageous configuration, it is possible that the endoscope can be rigid and the distal end region can be angled by means of a joint.
In accordance with a further advantageous configuration, it is possible that the endoscope can be flexible and the distal end region can be angled by means of a flexible material or a joint.
In accordance with a further advantageous configuration, the endoscope has a mechanical mechanism or electromechanical mechanism by means of which the distal end region can be angled.
In accordance with a further advantageous configuration, the transmission device can transmit the image by means of at least one transmission medium from the detection device to the evaluation device.
CA 02898554 2015-07-17 f PCT/EP2013/075042 - 8a -In accordance with a further advantageous configuration, optical or electrical image data can be detectable by means of mirrors, electrical lines, CA 02898554 2015-07-17 , . 2013P01205W0US
light guides or transparent or electrically conductive layers as transmission media.
In accordance with a further advantageous configuration, a position determining device can be formed, by means of which a position of the projection device and of the detection device can be determinable.
In accordance with a further advantageous configuration, the projection device can project white light onto the region of the internal space alternately to the color pattern, and the detection device can detect color images of the region alternately to 3D images which are calibratable by means of the white light.
In accordance with a further advantageous configuration, the display device can provide the 3D images and the color images of the region in real time for an operator.
In accordance with a further advantageous configuration, the detection data rate of the 3D images and of the color images can be in each case between 20 and 40 Hz, in particular 25 Hz.
In accordance with a further advantageous configuration, the evaluation device can fuse three-dimensional object coordinate data of the region with point cloud data of the region obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device.
The invention is described in greater detail on the basis of exemplary embodiments in association with the figures, in which:
figure la shows a first exemplary embodiment of an endoscope according to the invention in a first operating mode;
CA 02898554 20,15-07-17 , PCT/EP2013/075042 - 9a -. 2013P01205W0US
figure lb shows the first exemplary embodiment of an endoscope according to the invention in a second operating mode;
m .. 2013P01205W0US
figure lc shows an exemplary embodiment of a conventional endoscope;
figure 2 shows a second exemplary embodiment of an endoscope according to the invention;
figure 3 shows a third exemplary embodiment of an endoscope according to the invention;
figure 4a shows a fourth exemplary embodiment of an endoscope according to the invention in a first operating mode;
figure 4b shows the fourth exemplary embodiment of an endoscope according to the invention in a second operating mode;
figure 5 shows a fifth exemplary embodiment of an endoscope according to the invention;
figure 6 shows a sixth exemplary embodiment of an endoscope according to the invention;
figure 7 shows an exemplary embodiment of a conventional position determining apparatus;
figure 8 shows an exemplary embodiment of an endoscope according to the invention in an internal space at a first point in time;
figure 8b shows the exemplary embodiment of an endoscope according to the invention in accordance with figure 8a at a second point in time.
Figure la shows a first exemplary embodiment of an endoscope according to the invention in a first operating mode, in which the endoscope can be inserted into an abdominal space for example through a trocar. The illustrated endoscope for three-dimensionally detecting an internal space is in an initial state in which a longitudinal body having a distal end region extends along an original endoscope extent without being angled. In accordance with this exemplary embodiment, a projection device 1, for example a projector, in particular a slide projector, for projecting a color pattern, in particular a singly or redundantly coded color pattern, onto an object is arranged in the distal end region of the longitudinal body.
CA 02898554 2015-07-17 , POT/E22013/075042 - 10a -The projection , 2013P01205W0US
device 1 here is positioned completely in the distal end region. Further component parts of a projection device 1 can be a light source, for example at least one light emitting diode LED, drive electronics and further conventional projector elements. A detection device 3, for example a camera, for detecting an image of the color pattern projected onto the object is arranged outside the distal end region in the longitudinal body adjoining the distal end region. In accordance with the exemplary embodiment in accordance with figure la, the detection device 3 and projection device 1 are positioned one behind the other in this order in the direction of a distal end of the endoscope. The distal end region can be angled with respect to the original elongate endoscope extent here by up to 90 . Instances of angling by up to 1800 or for example by 1100, are likewise possible, in principle. In accordance with this exemplary embodiment, the projection device 1 is arranged in the bendable part of the endoscope. The detection device 3 is arranged with a viewing direction along the original elongate endoscope extent in the non-bendable part of the endoscope. The distal end region is embodied such that it can be angled partly with respect to the original elongate endoscope extent in such a way that the projection device I can be angled with respect to the original elongate endoscope extent. In all embodiments according to the invention, a transmission device 5 (not illustrated) is provided, by means of which, in particular, image data or images from the detection device 3 can be transmitted to an evaluation device 7 (not illustrated here). In principle, data transmission to and from the projection device 1 and the detection device 3 can be provided in all embodiments according to the invention. Driving and reading of the projection device 1 and of the detection device 3 can be implemented in this way.
Figure lb shows the first exemplary embodiment of an endoscope according to the invention in a second operating mode, in which three-dimensional data can be obtained. In this case, POT/Ei'2013/075042 - 12 the projector is situated in the angled region and the camera is situated in the long shaft or non-angled part of the longitudinal body of the endoscope. The distal end region has been angled at 90 with respect to the original elongate endoscope extent in such a way that the projection device 1 has likewise been angled by 90' with respect to the original elongate endoscope extent. In accordance with this operation mode, the projection device 1 and the detection device 3 in each case have a viewing direction substantially along the original elongate endoscope extent, in the case of a corresponding orientation in particular in the direction of an object, for example a surface of an internal space. It is particularly advantageous if the endoscope latches after being angled and is mechanically fixed or held in this way. An endoscopic apparatus that provides three-dimensional measurement data of surfaces with a high data quality is provided in this way. This is brought about by the endoscope being mechanically bendable at a defined location. A relatively large triangulation base in comparison with the prior art for the active triangulation used and thus a high depth resolution are brought about in this way. By way of example, it is possible to provide a depth resolution of 0.5 mm at a distance of 10 cm. What is advantageous in the case of the present invention is that the triangulation base can be disposed as a measure of an achievable depth resolution with an order of magnitude of 2-4 cm. In comparison with conventional endoscopes, a depth resolution can be increased by approximately the factor of 10 in the case of the endoscopes according to the invention.
Figure lc shows an exemplary embodiment of a conventional endoscope. In the case of such a conventional endoscope, both projector and camera optical unit are arranged at a front distal end face and have a viewing direction toward the front.
Given a typical diameter of such an endoscope in the region of approximately 10 mm, the triangulation base is thus in the CA 02898554 2015-07-17 , PCT/E22013/075042 - 12a range of approximately 3-4 mm.
CA 02898554 2015-07-17 , Figure 2 shows a second exemplary embodiment of an endoscope according to the invention. In accordance with this embodiment, a projection device 1 and a detection device 3 are arranged completely in the distal end region and are angled by 900 with respect to the original elongate endoscope extent. In accordance with figure 2, the projection device 1 is arranged at the distal end of the endoscope. The detection device 3 is positioned nearer to the proximal end of the endoscope alongside the projection device 1 in the distal end region. In the angled operating mode illustrated here, the projection device 1 and the detection device 3 in each case have a viewing direction substantially perpendicular to the elongate extent of the distal end region. In accordance with figure 2, a projector and a camera are arranged in the bendable part of the endoscope. A joint, for example, is arranged at the mechanically bendable location, wherein it is possible to deflect optical and electrical signals from the distal end region, by means of mirrors, wires, lights or transparent, electrically conductive layers. In accordance with figure 2, a projector and a receiver, which is embodied as a camera, are arranged in the bendable part of the endoscope or in the angled distal end region. A combination with a deflection device for deflecting optical and electrical signals is additionally possible, wherein a deflection can be intimated here by means of elements of the detection device 3. In the case of an interchanged arrangement, the deflection can be brought about by means of elements of the positioning device.
Figure 3 shows a third exemplary embodiment of an endoscope according to the invention. In accordance with this embodiment, a detection device 3 is arranged completely and a projection device 1 is arranged partly in the distal end region that can be angled. A portion of the projection device 1 that is not formed in the distal end region is formed in the longitudinal body adjoining the distal end region. For this purpose, by way of example, a camera can be formed in the angled region CA 02898554 2015-07-17 , and a projector can be formed partly in the angled region and partly in a rigid shaft. A transparency 4, for example, can be arranged in the transition region from the region that cannot be angled to the region that can be angled. As in all the embodiments, a transmission device 5 (not illustrated) is provided, by means of which, in particular, image data from the detection device 3 can be transmitted to an evaluation device 7. In principle, in all the embodiments, data transmission into and out of the distal end region or the angled distal end region and also to and from the projection device 1 and the detection device 3 can be provided or is provided.
In accordance with figure 3, the projection device 1 and detection device 3 in each case have a viewing direction substantially perpendicular to the elongate extent of the distal end region. Figure 3 shows with an arrow on the left of the detection device 3 that the two viewing directions of the projection device 1 and of the detection device 3 are rotatable about a rotation axis running along the elongate extent of the distal end region, in particular an axis of symmetry of the distal end region. A field of view of the endoscope can be effectively extended in this way. A panoramic image, for example, can be generated by means of a plurality of individual images being joined together. In accordance with figure 3, a projection device 1 is formed partly in the distal end region that can be angled. In this case, part of the projection device 1 remains in the region of the endoscope that cannot be angled.
In accordance with figure 3, the bendable distal end region is rotatable together with the field of view of a projector and the field of view of a camera about a cylinder axis of the distal end region, such that data fusion and an enlargement of a field of view are made possible by means of progressive measurement in the case of overlapping measurement fields or measurement regions of an endoscope.
Figure 4a shows a fourth exemplary embodiment of an endoscope PCT/EP2013/075042 - 14a -according to the invention in a first operating mode, which CA 02898554 2015-07-17 , is used for example for inserting the endoscope into an abdominal space or a technical internal space. Figure 4a shows a projector or a projection device 1 in a rigid part of an endoscope, wherein this proximal region can be referred to as endoscope shaft. Proximal means the side which is nearer to the operator. A distal side means the side that is formed further away from an operator. The projector can have a transparency 4;
the endoscope shaft bears the reference sign 2. Figure 4a shows an endoscope according to the invention in a first operating state, in which no angling was carried out. Bending can be made possible by means of a joint 6.
Figure 4b shows the fourth exemplary embodiment of an endoscope according to the invention in a second operating state. For this purpose, a camera as detection device 3 is positioned in the distal end region that can be angled, and is rotated out of the position in the first operating state or initial state here by 90 . The bending is made possible here by means of a joint 6. Other configurations are likewise possible, in principle. In figure 4b, projector has a viewing direction downward. In figure 4b, the camera or detection device 3 is likewise formed with a viewing direction downward in the bendable part of the endoscope.
Figure 5 shows a fifth exemplary embodiment of an endoscope according to the invention. A detection device 3 is formed outside the longitudinal body and a projection device 1 is formed in the distal end region. Therefore, a portion of the projection device 1 and of the detection device 3 which is not formed in the distal end region is formed outside the longitudinal body at a side of a proximal end region of the longitudinal body. Proceeding from the detection device 3, an image guide device 13 is formed from outside the longitudinal body in the longitudinal body to an objective 15 adjoining the distal end region in the longitudinal body.
CA 02898554 2015-07-17 , By means of a light guide, an image of an object can thus be detected by the detection device 3 by means of the objective 15. In accordance with figure 5, the projection device 1 is formed in the distal end region and receives from a light source 17 outside the longitudinal body, by means of a light guide device 19, light for projecting color patterns and/or for illuminating an object with white light. Since the light source 17 is external, it can provide a high light power. Heat losses can simply be dissipated. The projection device 1 here can be formed completely in the distal end region.
Figure 6 shows a sixth exemplary embodiment of an endoscope according to the invention. A projection device 1 is formed outside the longitudinal body and a detection device 3 is formed in the distal end region. Therefore, a portion of the projection device 1 and of the detection device 3 which is not formed in the distal end region is formed outside the longitudinal body at a side of a proximal end region of the longitudinal body. Proceeding from the projection device 1, an image guide device 13 is formed from outside the longitudinal body in the longitudinal body to an objective 15 adjoining the distal end region in the longitudinal body. By means of a light guide, a color pattern can be projected onto an object by means of the objective 15. The detection device 3 here is formed completely in the distal end region.
Figure 7 shows an exemplary embodiment of a conventional position determining apparatus which can supplement an endoscope according to the invention. If an endoscope according to the invention is formed with a position determining apparatus, which can likewise be referred to as a tracking apparatus, a measured and detected surface of an operation site, for example, can be linked with the endoscope position obtained. Figure 7 shows a conventional exemplary embodiment using electromagnetic or optical tracking. Further alternatives include fitting distinctive CA 02898554 2015-07-17 , PCT/EP20:3/075042 - 17 -structures, for example spheres, in an outer region of the endoscope or tracking by means of optical triangulation.
Further position determining apparatuses are likewise possible.
Figure 8a shows an exemplary embodiment of an endoscope according to the invention in an internal space at a first point in time. In this case, in accordance with this exemplary embodiment, the endoscope is optimally adapted to the band recognitions of minimally invasive surgery. For this purpose, the endoscope E according to the invention is formed as a measured endoscope and is insertable and here inserted into an air-filled abdominal space, as an example of internal space, through a trocar. The insertion took place from above here, the intention being to carry out an operation on a liver L. The endoscope E according to the invention is deflected by approximately 90 at a defined bend here at the first point in time, such that the viewing direction of a projection device 1 in the form of a projector and of a detection device 3 in the form of an imaging optical unit here is directed downward at the operation region in the interior of the abdominal space.
The endoscope E according to the invention enables an enlargement of a triangulation base and measurements of surfaces and the 3D extents thereof in real time. According to the invention, it is now possible to enlarge a usable cross-sectional area for the optical components of the endoscope E
according to the invention. The Lagrange invariant can be increased, this being a measure of the optical information transmission performance in optics. In this way, an effectively higher lateral resolution and a depth resolution are brought about particularly in the 3D area in the endoscope. Equally, in comparison with the prior art in accordance with figure lc, it is possible to effectively enlarge the cross-sectional area for supplying light, which corresponds to an increase in the etendue. The measurement surfaces detectable in real time are identified by M in figures 8a and 8b. A position determining PCT/EP2013/075042 - 17a device 9 advantageously detects the posirlion of the , 2013P01205WOUS
projection device 1 and of the detection device 3 and also, in particular, the position of the triangulation base and makes it possible in this way likewise to determine the positions of the detected surface structures relative to an external coordinate system. A further position determining device 9 can be arranged on an additional instrument I, such that the position thereof can likewise be determined with respect to the external coordinate system. It is thereby possible to localize the measuring system relative to the instrument. In this way, an operator can be supplied with additional information for operation within an internal space. Reference sign W identifies a region to be treated or processed in the internal space in which the endoscope E and instrument I have been introduced. A
transmission device 5 (not illustrated here) transmits the image generated by the detection device 3 to an external evaluation device 7 for processing the image to form three-dimensional object coordinates. By means of a display device 11 (not illustrated here), an operator can see a 3D image of a region W of the internal space. The projection device 1 can project white light onto the region W of the internal space alternately to the color pattern, and the detection device 3 can detect color images of the region W alternately to 3D
images which are calibratable by means of the white light. In this way, in addition to the 3D images, the display device 11 can provide color images of the region W in real time for an operator. In the case of such alternate image recording with structured illumination and illumination with white light it is possible to calculate depth data, when the light white recording in this case can serve for color correction of color fringes and a disturbing influence of the color of the object or of the region W can be reduced in this way. The alternate image recording with structured illumination and illumination with white light likewise makes it possible to visualize a region W to be processed, for example an operation site for a surgeon, by means of a display of a color image. At an image rate of 50 hertz, the CA 02898554 2015-07-17 , 201.3201205WOUS
surface of an operation seen or of a 3D surface region W can be calculated in real time - for example at 25 Hz - and can be used as a data set for navigation, specifically guiding the surgeon to the disease center or the operator to the site of use, and are represented on the display device 11 for the operator. At the same time, the color image can be displayed in real time - for example at an image rate of 25 Hz - for the purpose of orientation for the operator or the surgeon in the site of use or abdominal space for example on a monitor or a head-up display. Furthermore, information for the navigation or guiding can be inserted on a or the monitor, for example arrows.
Figure 8b shows the exemplary embodiment of an endoscope according to the invention in accordance with figure 8a during a second point in time. Reference signs identical to those in figure 8a identify identical elements. In accordance with figure 8b, an embodiment of an endoscope E can be used in which the projection device I can project white light on the region W
of the internal space alternately with respect to the coded color pattern and the detection device 3 can detect color image data of said region W alternately with respect to calibratable 3D image data.
Figure 8b shows the second point in time, at which the operator, specifically here a surgeon, uses point cloud data of the region W obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device, in addition to images and 3D images. In this case, the evaluation device 7 can fuse three-dimensional object coordinate data of the region W or a 3D image with a point cloud data of the region (W) that are obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device. By means of this additional information, the region to be treated, for example a liver L, can be detected by =
PCT/EP2013/075042 - 19a -means of the detection device 3 in such a way that defective locations or diseased tissue, for example a tumor T, can be localized and removed. When a 3D endoscope according to the invention is used as measuring means for the three-dimensional measurement of a surface of an organ, the fusion with in particular preoperatively obtained point clouds is additionally performed in accordance with figure 8b. Such point clouds may have been provided for example by means of nuclear spin tomography device or a magnetic resonance imaging device. In this case, a preoperatively obtained surface of an organ is determined in a point cloud and is deformed in a data set in such a way that the point cloud has the form of the surface form measured by means of an endoscope E according to the invention. In this case, the points of the point cloud are elastically linked with one another, such that regions within an organ correspondingly concomitantly deform during a surface deformation and, if appropriate, adopt a new position. If, for example, the tumor T is situated within an organ, for example the liver L, and if the tumor T is localizable in the preoperatively obtained point cloud, then a change in the position of the tumor T can be determined by means of the 3D/3D
data fusion and used as information for the navigation of the surgeon to the disease center. The endoscopes according to the invention are particularly advantageous high-resolution 3D
endoscopes in particular for minimally invasive surgery. In principle, the endoscopes according to the invention are not restricted to medical applications. Further areas of application are found in technical endoscopy or wherever internal spaces have to be detected, tested, monitored or processed.
An endoscope for three-dimensionally detecting an internal space R of a body are disposed, wherein a projection device 1 for projecting a color pattern onto a region W of the internal space R and a detection device 3 for detecting an image of the color pattern projected onto the region W are positioned at least partly in a distal end region of an elongate endoscope PCT/EP2013/075042 - 20a -extent and the distal end region can be angled by up to 180 with respect to the original elongate endoscope extent. A
triangulation base for evaluating images by means of active triangulation for generating 3D images of the region W can be simply and effectively enlarged in this way. Such endoscopes can particularly advantageously be employed in minimally invasive surgery or in technical endoscopy.
Description Endoscope, particularly for minimally invasive surgery The invention relates to an endoscope, particularly for minimally invasive surgery, according to the preamble of the main claim.
In comparison with frequently conventional open surgery, numerous methodological-technical restrictions apply to minimally invasive or laparoscopic and in particular scarless surgery. Said restrictions relate primarily to visualization, spatial orientation, assessment of the tissue constitution and the spatial confinement of the work area with greatly reduced degrees of freedom. For this reason, complex interventions, in particular, have hitherto not yet been able to be carried out minimally invasively, even though this would be inherently very desirable.
Therefore, intensive research and development efforts are being made globally in order to extend the applicability of minimally invasive surgery.
One major disadvantage of conventional minimally invasive surgery is missing or inaccurate information about the third dimension, since only the organ surfaces are viewed and, for example, the sense of touch cannot be used to localize a tumor internally in an organ. The depth information could be conveyed, in principle, by the projection of volume data sets obtained preoperatively, but this form of augmented or enhanced reality conventionally fails for lack of reliable referencing.
In comparison with preoperative diagnostics, intraoperatively a more or less pronounced position and shape change, for example of an intra-abdominal anatomy, can always occur, to which a preoperative data set has to be adapted in each case. Such an POT/EP2013/075042 - ld -adaptation would be possible in terms of software if, in comparison CA 02898554 2015-07-17 , with the prior art, more exact information were available about a current surface of an organ for example in an abdominal space. In addition, conventionally a field of view is greatly restricted.
Numerous approaches propose a precise, continuous depth measurement in real time. Conventionally, it is not possible to determine accurate distances between a respective anatomy and the measurement objects used at every point in time of an intervention. The absence of this information is a cause of a large number of problems that currently still exist.
For the further development of medical operations via natural orifices of the body, a precise 3D metrology is the key technology. Without a successful implementation, NOTES (Natural Orifice Transluminal Endoscopic Surgery), or the minimally invasive surgery without scars, which involves operating by means of access through natural orifices of the body, will not be able to be introduced into clinical care. The use of mechatronic auxiliary systems is essential for NOTES. Said systems in turn necessarily require a reliably functioning depth or 3D metrology for collision avoidance, for the compensation of breathing- or respiration-dictated organ deflections and a large number of further functions.
Various solution approaches used hitherto in other technical fields can be used to provide 3D information and corresponding 3D metrology.
Stereoscopy Stereoscopic triangulation is a conventional principle of distance measurement. In this case, an object is imaged from two observation directions by means of cameras. If a distinctive point is recognized in both recordings, then CA 02898554 2015-07-17 , given a known distance between the cameras, the so-called base, a triangle is spanned which is uniquely determined with the base value and two angles and enables the distance of the point to be calculated. What is usually disadvantageous here, however, is the fact that there are too few distinctive points in the object and too few corresponding points are thus found in the cameras. Such a problem is referred to as the correspondence problem.
Phase triangulation In order to avoid such a correspondence problem, so-called active triangulation has conventionally been used, which projects from one direction known patterns or, as in the case of phase triangulation, a sequence of sinusoidal patterns onto an object. As a result of the imaging of the object from another direction, the pattern appears distorted depending on the shape of the pattern surface, wherein the three-dimensional surface can in turn be calculated from this distortion, which is likewise referred to as a phase shift. This procedure enables even totally contrastless and markerless surfaces to be measured. What is disadvantageous about this type of 3D
measurement in the field of minimally invasive surgery is an only minimal space for accommodating a camera and a projector -fitted at an angle - for projecting pattern sequences. A
further disadvantage is that the position with respect to the object must not be altered during a projection sequence, since otherwise the 3D coordinate calculation is greatly beset by errors.
Time of flight The disadvantage of the 3D coordinate calculation beset by errors on account of an object movement likewise occurs in the so-called time of flight (TOF) methods. Here, likewise, from a CA 02898554 2015-07-17 , PCT/E22013/075042 - 3a -location of the object surface, at least four intensity values are measured for different times of flight of an intensity-modulated transmission signal. A computation of these , 2013P01205WOUS
intensity values produces a respective distance value. A
further challenge however is in particular the measurement of the time-of-flight differences caused by distance differences in the millimeters range given the very high speed of light in the region of 300 000 km per second. Conventional systems can measure the distance of a single object point at a resolution of one millimeter by using highly developed detectors and electronics. Only inadequate values for surgery in the centimeters range are achieved for planar TOF distance sensors.
Structure from motion This method is based on the fact that, in principle, by means of the motion of a camera in front of an object, many images are recorded from different directions and triangulation is made possible again, in principle, in this way. However, the so-called correspondence problem arises again in this case, that is to say that a distinctive point has to be recognized in the respective sequential images. Furthermore, it is not possible to calculate absolute, but rather only relative values, since the triangulation base, the distance and the orientation between the temporal recordings are not known or would additionally have to be measured by tracking systems.
The problem addressed by the present invention is that of providing an endoscope such that a visualization, a spatial orientation and/or an assessment of an object, in particular of tissue, in particular in the case of a spatial confinement of a work volume with reduced degrees of freedom, are/is improved and simplified in comparison with conventional systems. In particular, an applicability to minimally invasive surgery is intended to be extended. Complex minimally invasive interventions are likewise intended to be implementable. A
precise, continuous depth measurement in real time is intended to be made possible and accurate distances between endoscope and object are intended to be determinable at every point in PC1/EP2013/075042 - 4a time of an intervention. An , 2013P01205WOUS
endoscopic apparatus is intended to be provided such that 3D
measurement data of surfaces, in particular in the field of minimally invasive surgery, are generated with a higher data quality in comparison with the prior art.
For the integration of optical systems particularly in the field of minimally invasive surgery (MIC), it is important that the optical systems are sufficiently miniaturizable and nevertheless do not lose their performance in the sense of imaging or measurement accuracy. It is necessary to overcome the disadvantage that a reduction of dimensions in an optical system generally likewise means a loss of information transmission capacity, be it that the size of a field of view is reduced or that the resolution capability is reduced. This concerns 3D metrology, in particular since the latter has to likewise transmit the third dimension.
The problem is solved by means of an endoscope as claimed in the main claim.
In accordance with one aspect, an endoscope for three-dimensionally detecting a region of an internal space is proposed, wherein the endoscope extends along an original elongate endoscope extent as a longitudinal body having a distal end region which can be angled by up to 1800, in parti-cular up to 1100 or 90 , with respect to the original elongate endoscope extent, wherein an apparatus for three-dimensionally detecting the region by means of active triangulation is formed at least partly in the distal end region.
The three-dimensionally measuring optical system proposed makes it possible to produce measurements of distance to individual points of a surface of an internal space and more exact information about an internal space of a body. An endoscopic apparatus is proposed which, particularly for minimally invasive surgery, provides three-dimensional measurement data PCT/EP2013/075042 - 5a -, 2013P01205W0US
of surfaces with higher data quality in comparison with CA 02898554 2015-07-17 , the prior art. Conventional so-called active triangulation is particularly advantageously used, which projects from one direction known patterns or, as in the case of phase triangulation, a sequence of sinusoidal patterns onto an object. Configurations such as are known from DE 10 232 690 Al are particularly advantageous.
Further advantageous configurations are claimed in association with the dependent claims.
In accordance with one advantageous configuration, the apparatus for three-dimensionally detecting the region can have a projection device for projecting an, in particular redundantly coded, color pattern onto the region and a detection device for detecting an image of the color pattern projected onto the region.
In accordance with a further advantageous configuration, a transmission device can be designed for transmitting the image generated by the detection device to an evaluation device for processing the image to form three-dimensional object coordinates which can be represented as a 3D image for an operator by means of a display device.
In accordance with a further advantageous configuration, the projection device and/or the detection device can be formed at least partly in the distal end region.
In accordance with a further advantageous configuration, the projection device and the detection device can be formed completely or one of the two can be formed completely and the other is formed partly in the distal end region in such a way that both have in each case a viewing direction substantially perpendicular to the elongate extent of the angled distal end region.
In accordance with a further advantageous configuration, the two viewing directions can be rotatable about a rotation axis running along the elongate extent of the distal end region, in particular an axis of symmetry of the distal end region. A
restricted field of view can be extended in this way since, by means of a depth map, a large number of individual images of the internal space can be joined together to form a virtual panorama, which can likewise be referred to as "mosaicing" or "stitching". Such an extension of the field of view can considerably facilitate performance of an operation, for example, and effectively improve a safety level.
In accordance with a further advantageous configuration, either the projection device or the detection device can be formed completely and the other is not formed in the distal end region and both can have substantially parallel viewing directions in an angled state.
In accordance with a further advantageous configuration, the two viewing directions substantially can run along the original elongate endoscope extent.
In accordance with a further advantageous configuration, it is possible that the endoscope can be angled by approximately 900 with respect to the regional elongate endoscope extent.
In accordance with a further advantageous configuration, a portion of the projection device and of the detection device which is not formed in the distal end region can be formed in the longitudinal body adjoining the distal end region.
In accordance with a further advantageous configuration, a portion of the projection device and of the detection device which is not formed in the distal end region can be formed outside the longitudinal body at a side of a proximal end region of the longitudinal body.
PCT/EP2013/075042 - a -In accordance with a further advantageous configuration, the detection device or the projection device can be formed outside the longitudinal body and the other is formed in the distal end region.
In accordance with a further advantageous configuration, proceeding from the detection device or projection device formed outside the longitudinal body, an image guide device can be formed into the longitudinal body to an objective adjoining the distal end region in the distal end region.
In accordance with a further advantageous configuration, if the projection device is formed in the distal end region, a light guide device to the projection device can be formed from a light source outside the longitudinal body into the longitudinal body.
In accordance with a further advantageous configuration, it is possible that the endoscope can be rigid and the distal end region can be angled by means of a joint.
In accordance with a further advantageous configuration, it is possible that the endoscope can be flexible and the distal end region can be angled by means of a flexible material or a joint.
In accordance with a further advantageous configuration, the endoscope has a mechanical mechanism or electromechanical mechanism by means of which the distal end region can be angled.
In accordance with a further advantageous configuration, the transmission device can transmit the image by means of at least one transmission medium from the detection device to the evaluation device.
CA 02898554 2015-07-17 f PCT/EP2013/075042 - 8a -In accordance with a further advantageous configuration, optical or electrical image data can be detectable by means of mirrors, electrical lines, CA 02898554 2015-07-17 , . 2013P01205W0US
light guides or transparent or electrically conductive layers as transmission media.
In accordance with a further advantageous configuration, a position determining device can be formed, by means of which a position of the projection device and of the detection device can be determinable.
In accordance with a further advantageous configuration, the projection device can project white light onto the region of the internal space alternately to the color pattern, and the detection device can detect color images of the region alternately to 3D images which are calibratable by means of the white light.
In accordance with a further advantageous configuration, the display device can provide the 3D images and the color images of the region in real time for an operator.
In accordance with a further advantageous configuration, the detection data rate of the 3D images and of the color images can be in each case between 20 and 40 Hz, in particular 25 Hz.
In accordance with a further advantageous configuration, the evaluation device can fuse three-dimensional object coordinate data of the region with point cloud data of the region obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device.
The invention is described in greater detail on the basis of exemplary embodiments in association with the figures, in which:
figure la shows a first exemplary embodiment of an endoscope according to the invention in a first operating mode;
CA 02898554 20,15-07-17 , PCT/EP2013/075042 - 9a -. 2013P01205W0US
figure lb shows the first exemplary embodiment of an endoscope according to the invention in a second operating mode;
m .. 2013P01205W0US
figure lc shows an exemplary embodiment of a conventional endoscope;
figure 2 shows a second exemplary embodiment of an endoscope according to the invention;
figure 3 shows a third exemplary embodiment of an endoscope according to the invention;
figure 4a shows a fourth exemplary embodiment of an endoscope according to the invention in a first operating mode;
figure 4b shows the fourth exemplary embodiment of an endoscope according to the invention in a second operating mode;
figure 5 shows a fifth exemplary embodiment of an endoscope according to the invention;
figure 6 shows a sixth exemplary embodiment of an endoscope according to the invention;
figure 7 shows an exemplary embodiment of a conventional position determining apparatus;
figure 8 shows an exemplary embodiment of an endoscope according to the invention in an internal space at a first point in time;
figure 8b shows the exemplary embodiment of an endoscope according to the invention in accordance with figure 8a at a second point in time.
Figure la shows a first exemplary embodiment of an endoscope according to the invention in a first operating mode, in which the endoscope can be inserted into an abdominal space for example through a trocar. The illustrated endoscope for three-dimensionally detecting an internal space is in an initial state in which a longitudinal body having a distal end region extends along an original endoscope extent without being angled. In accordance with this exemplary embodiment, a projection device 1, for example a projector, in particular a slide projector, for projecting a color pattern, in particular a singly or redundantly coded color pattern, onto an object is arranged in the distal end region of the longitudinal body.
CA 02898554 2015-07-17 , POT/E22013/075042 - 10a -The projection , 2013P01205W0US
device 1 here is positioned completely in the distal end region. Further component parts of a projection device 1 can be a light source, for example at least one light emitting diode LED, drive electronics and further conventional projector elements. A detection device 3, for example a camera, for detecting an image of the color pattern projected onto the object is arranged outside the distal end region in the longitudinal body adjoining the distal end region. In accordance with the exemplary embodiment in accordance with figure la, the detection device 3 and projection device 1 are positioned one behind the other in this order in the direction of a distal end of the endoscope. The distal end region can be angled with respect to the original elongate endoscope extent here by up to 90 . Instances of angling by up to 1800 or for example by 1100, are likewise possible, in principle. In accordance with this exemplary embodiment, the projection device 1 is arranged in the bendable part of the endoscope. The detection device 3 is arranged with a viewing direction along the original elongate endoscope extent in the non-bendable part of the endoscope. The distal end region is embodied such that it can be angled partly with respect to the original elongate endoscope extent in such a way that the projection device I can be angled with respect to the original elongate endoscope extent. In all embodiments according to the invention, a transmission device 5 (not illustrated) is provided, by means of which, in particular, image data or images from the detection device 3 can be transmitted to an evaluation device 7 (not illustrated here). In principle, data transmission to and from the projection device 1 and the detection device 3 can be provided in all embodiments according to the invention. Driving and reading of the projection device 1 and of the detection device 3 can be implemented in this way.
Figure lb shows the first exemplary embodiment of an endoscope according to the invention in a second operating mode, in which three-dimensional data can be obtained. In this case, POT/Ei'2013/075042 - 12 the projector is situated in the angled region and the camera is situated in the long shaft or non-angled part of the longitudinal body of the endoscope. The distal end region has been angled at 90 with respect to the original elongate endoscope extent in such a way that the projection device 1 has likewise been angled by 90' with respect to the original elongate endoscope extent. In accordance with this operation mode, the projection device 1 and the detection device 3 in each case have a viewing direction substantially along the original elongate endoscope extent, in the case of a corresponding orientation in particular in the direction of an object, for example a surface of an internal space. It is particularly advantageous if the endoscope latches after being angled and is mechanically fixed or held in this way. An endoscopic apparatus that provides three-dimensional measurement data of surfaces with a high data quality is provided in this way. This is brought about by the endoscope being mechanically bendable at a defined location. A relatively large triangulation base in comparison with the prior art for the active triangulation used and thus a high depth resolution are brought about in this way. By way of example, it is possible to provide a depth resolution of 0.5 mm at a distance of 10 cm. What is advantageous in the case of the present invention is that the triangulation base can be disposed as a measure of an achievable depth resolution with an order of magnitude of 2-4 cm. In comparison with conventional endoscopes, a depth resolution can be increased by approximately the factor of 10 in the case of the endoscopes according to the invention.
Figure lc shows an exemplary embodiment of a conventional endoscope. In the case of such a conventional endoscope, both projector and camera optical unit are arranged at a front distal end face and have a viewing direction toward the front.
Given a typical diameter of such an endoscope in the region of approximately 10 mm, the triangulation base is thus in the CA 02898554 2015-07-17 , PCT/E22013/075042 - 12a range of approximately 3-4 mm.
CA 02898554 2015-07-17 , Figure 2 shows a second exemplary embodiment of an endoscope according to the invention. In accordance with this embodiment, a projection device 1 and a detection device 3 are arranged completely in the distal end region and are angled by 900 with respect to the original elongate endoscope extent. In accordance with figure 2, the projection device 1 is arranged at the distal end of the endoscope. The detection device 3 is positioned nearer to the proximal end of the endoscope alongside the projection device 1 in the distal end region. In the angled operating mode illustrated here, the projection device 1 and the detection device 3 in each case have a viewing direction substantially perpendicular to the elongate extent of the distal end region. In accordance with figure 2, a projector and a camera are arranged in the bendable part of the endoscope. A joint, for example, is arranged at the mechanically bendable location, wherein it is possible to deflect optical and electrical signals from the distal end region, by means of mirrors, wires, lights or transparent, electrically conductive layers. In accordance with figure 2, a projector and a receiver, which is embodied as a camera, are arranged in the bendable part of the endoscope or in the angled distal end region. A combination with a deflection device for deflecting optical and electrical signals is additionally possible, wherein a deflection can be intimated here by means of elements of the detection device 3. In the case of an interchanged arrangement, the deflection can be brought about by means of elements of the positioning device.
Figure 3 shows a third exemplary embodiment of an endoscope according to the invention. In accordance with this embodiment, a detection device 3 is arranged completely and a projection device 1 is arranged partly in the distal end region that can be angled. A portion of the projection device 1 that is not formed in the distal end region is formed in the longitudinal body adjoining the distal end region. For this purpose, by way of example, a camera can be formed in the angled region CA 02898554 2015-07-17 , and a projector can be formed partly in the angled region and partly in a rigid shaft. A transparency 4, for example, can be arranged in the transition region from the region that cannot be angled to the region that can be angled. As in all the embodiments, a transmission device 5 (not illustrated) is provided, by means of which, in particular, image data from the detection device 3 can be transmitted to an evaluation device 7. In principle, in all the embodiments, data transmission into and out of the distal end region or the angled distal end region and also to and from the projection device 1 and the detection device 3 can be provided or is provided.
In accordance with figure 3, the projection device 1 and detection device 3 in each case have a viewing direction substantially perpendicular to the elongate extent of the distal end region. Figure 3 shows with an arrow on the left of the detection device 3 that the two viewing directions of the projection device 1 and of the detection device 3 are rotatable about a rotation axis running along the elongate extent of the distal end region, in particular an axis of symmetry of the distal end region. A field of view of the endoscope can be effectively extended in this way. A panoramic image, for example, can be generated by means of a plurality of individual images being joined together. In accordance with figure 3, a projection device 1 is formed partly in the distal end region that can be angled. In this case, part of the projection device 1 remains in the region of the endoscope that cannot be angled.
In accordance with figure 3, the bendable distal end region is rotatable together with the field of view of a projector and the field of view of a camera about a cylinder axis of the distal end region, such that data fusion and an enlargement of a field of view are made possible by means of progressive measurement in the case of overlapping measurement fields or measurement regions of an endoscope.
Figure 4a shows a fourth exemplary embodiment of an endoscope PCT/EP2013/075042 - 14a -according to the invention in a first operating mode, which CA 02898554 2015-07-17 , is used for example for inserting the endoscope into an abdominal space or a technical internal space. Figure 4a shows a projector or a projection device 1 in a rigid part of an endoscope, wherein this proximal region can be referred to as endoscope shaft. Proximal means the side which is nearer to the operator. A distal side means the side that is formed further away from an operator. The projector can have a transparency 4;
the endoscope shaft bears the reference sign 2. Figure 4a shows an endoscope according to the invention in a first operating state, in which no angling was carried out. Bending can be made possible by means of a joint 6.
Figure 4b shows the fourth exemplary embodiment of an endoscope according to the invention in a second operating state. For this purpose, a camera as detection device 3 is positioned in the distal end region that can be angled, and is rotated out of the position in the first operating state or initial state here by 90 . The bending is made possible here by means of a joint 6. Other configurations are likewise possible, in principle. In figure 4b, projector has a viewing direction downward. In figure 4b, the camera or detection device 3 is likewise formed with a viewing direction downward in the bendable part of the endoscope.
Figure 5 shows a fifth exemplary embodiment of an endoscope according to the invention. A detection device 3 is formed outside the longitudinal body and a projection device 1 is formed in the distal end region. Therefore, a portion of the projection device 1 and of the detection device 3 which is not formed in the distal end region is formed outside the longitudinal body at a side of a proximal end region of the longitudinal body. Proceeding from the detection device 3, an image guide device 13 is formed from outside the longitudinal body in the longitudinal body to an objective 15 adjoining the distal end region in the longitudinal body.
CA 02898554 2015-07-17 , By means of a light guide, an image of an object can thus be detected by the detection device 3 by means of the objective 15. In accordance with figure 5, the projection device 1 is formed in the distal end region and receives from a light source 17 outside the longitudinal body, by means of a light guide device 19, light for projecting color patterns and/or for illuminating an object with white light. Since the light source 17 is external, it can provide a high light power. Heat losses can simply be dissipated. The projection device 1 here can be formed completely in the distal end region.
Figure 6 shows a sixth exemplary embodiment of an endoscope according to the invention. A projection device 1 is formed outside the longitudinal body and a detection device 3 is formed in the distal end region. Therefore, a portion of the projection device 1 and of the detection device 3 which is not formed in the distal end region is formed outside the longitudinal body at a side of a proximal end region of the longitudinal body. Proceeding from the projection device 1, an image guide device 13 is formed from outside the longitudinal body in the longitudinal body to an objective 15 adjoining the distal end region in the longitudinal body. By means of a light guide, a color pattern can be projected onto an object by means of the objective 15. The detection device 3 here is formed completely in the distal end region.
Figure 7 shows an exemplary embodiment of a conventional position determining apparatus which can supplement an endoscope according to the invention. If an endoscope according to the invention is formed with a position determining apparatus, which can likewise be referred to as a tracking apparatus, a measured and detected surface of an operation site, for example, can be linked with the endoscope position obtained. Figure 7 shows a conventional exemplary embodiment using electromagnetic or optical tracking. Further alternatives include fitting distinctive CA 02898554 2015-07-17 , PCT/EP20:3/075042 - 17 -structures, for example spheres, in an outer region of the endoscope or tracking by means of optical triangulation.
Further position determining apparatuses are likewise possible.
Figure 8a shows an exemplary embodiment of an endoscope according to the invention in an internal space at a first point in time. In this case, in accordance with this exemplary embodiment, the endoscope is optimally adapted to the band recognitions of minimally invasive surgery. For this purpose, the endoscope E according to the invention is formed as a measured endoscope and is insertable and here inserted into an air-filled abdominal space, as an example of internal space, through a trocar. The insertion took place from above here, the intention being to carry out an operation on a liver L. The endoscope E according to the invention is deflected by approximately 90 at a defined bend here at the first point in time, such that the viewing direction of a projection device 1 in the form of a projector and of a detection device 3 in the form of an imaging optical unit here is directed downward at the operation region in the interior of the abdominal space.
The endoscope E according to the invention enables an enlargement of a triangulation base and measurements of surfaces and the 3D extents thereof in real time. According to the invention, it is now possible to enlarge a usable cross-sectional area for the optical components of the endoscope E
according to the invention. The Lagrange invariant can be increased, this being a measure of the optical information transmission performance in optics. In this way, an effectively higher lateral resolution and a depth resolution are brought about particularly in the 3D area in the endoscope. Equally, in comparison with the prior art in accordance with figure lc, it is possible to effectively enlarge the cross-sectional area for supplying light, which corresponds to an increase in the etendue. The measurement surfaces detectable in real time are identified by M in figures 8a and 8b. A position determining PCT/EP2013/075042 - 17a device 9 advantageously detects the posirlion of the , 2013P01205WOUS
projection device 1 and of the detection device 3 and also, in particular, the position of the triangulation base and makes it possible in this way likewise to determine the positions of the detected surface structures relative to an external coordinate system. A further position determining device 9 can be arranged on an additional instrument I, such that the position thereof can likewise be determined with respect to the external coordinate system. It is thereby possible to localize the measuring system relative to the instrument. In this way, an operator can be supplied with additional information for operation within an internal space. Reference sign W identifies a region to be treated or processed in the internal space in which the endoscope E and instrument I have been introduced. A
transmission device 5 (not illustrated here) transmits the image generated by the detection device 3 to an external evaluation device 7 for processing the image to form three-dimensional object coordinates. By means of a display device 11 (not illustrated here), an operator can see a 3D image of a region W of the internal space. The projection device 1 can project white light onto the region W of the internal space alternately to the color pattern, and the detection device 3 can detect color images of the region W alternately to 3D
images which are calibratable by means of the white light. In this way, in addition to the 3D images, the display device 11 can provide color images of the region W in real time for an operator. In the case of such alternate image recording with structured illumination and illumination with white light it is possible to calculate depth data, when the light white recording in this case can serve for color correction of color fringes and a disturbing influence of the color of the object or of the region W can be reduced in this way. The alternate image recording with structured illumination and illumination with white light likewise makes it possible to visualize a region W to be processed, for example an operation site for a surgeon, by means of a display of a color image. At an image rate of 50 hertz, the CA 02898554 2015-07-17 , 201.3201205WOUS
surface of an operation seen or of a 3D surface region W can be calculated in real time - for example at 25 Hz - and can be used as a data set for navigation, specifically guiding the surgeon to the disease center or the operator to the site of use, and are represented on the display device 11 for the operator. At the same time, the color image can be displayed in real time - for example at an image rate of 25 Hz - for the purpose of orientation for the operator or the surgeon in the site of use or abdominal space for example on a monitor or a head-up display. Furthermore, information for the navigation or guiding can be inserted on a or the monitor, for example arrows.
Figure 8b shows the exemplary embodiment of an endoscope according to the invention in accordance with figure 8a during a second point in time. Reference signs identical to those in figure 8a identify identical elements. In accordance with figure 8b, an embodiment of an endoscope E can be used in which the projection device I can project white light on the region W
of the internal space alternately with respect to the coded color pattern and the detection device 3 can detect color image data of said region W alternately with respect to calibratable 3D image data.
Figure 8b shows the second point in time, at which the operator, specifically here a surgeon, uses point cloud data of the region W obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device, in addition to images and 3D images. In this case, the evaluation device 7 can fuse three-dimensional object coordinate data of the region W or a 3D image with a point cloud data of the region (W) that are obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device. By means of this additional information, the region to be treated, for example a liver L, can be detected by =
PCT/EP2013/075042 - 19a -means of the detection device 3 in such a way that defective locations or diseased tissue, for example a tumor T, can be localized and removed. When a 3D endoscope according to the invention is used as measuring means for the three-dimensional measurement of a surface of an organ, the fusion with in particular preoperatively obtained point clouds is additionally performed in accordance with figure 8b. Such point clouds may have been provided for example by means of nuclear spin tomography device or a magnetic resonance imaging device. In this case, a preoperatively obtained surface of an organ is determined in a point cloud and is deformed in a data set in such a way that the point cloud has the form of the surface form measured by means of an endoscope E according to the invention. In this case, the points of the point cloud are elastically linked with one another, such that regions within an organ correspondingly concomitantly deform during a surface deformation and, if appropriate, adopt a new position. If, for example, the tumor T is situated within an organ, for example the liver L, and if the tumor T is localizable in the preoperatively obtained point cloud, then a change in the position of the tumor T can be determined by means of the 3D/3D
data fusion and used as information for the navigation of the surgeon to the disease center. The endoscopes according to the invention are particularly advantageous high-resolution 3D
endoscopes in particular for minimally invasive surgery. In principle, the endoscopes according to the invention are not restricted to medical applications. Further areas of application are found in technical endoscopy or wherever internal spaces have to be detected, tested, monitored or processed.
An endoscope for three-dimensionally detecting an internal space R of a body are disposed, wherein a projection device 1 for projecting a color pattern onto a region W of the internal space R and a detection device 3 for detecting an image of the color pattern projected onto the region W are positioned at least partly in a distal end region of an elongate endoscope PCT/EP2013/075042 - 20a -extent and the distal end region can be angled by up to 180 with respect to the original elongate endoscope extent. A
triangulation base for evaluating images by means of active triangulation for generating 3D images of the region W can be simply and effectively enlarged in this way. Such endoscopes can particularly advantageously be employed in minimally invasive surgery or in technical endoscopy.
Claims (16)
1. An endoscope for three-dimensionally detecting a region (W) of an internal space (R), wherein the endoscope extends along an original elongate endoscope extent as a longitudinal body having a distal end region which can be angled by up to 180° with respect to the original elongate endoscope extent, wherein an apparatus for three-dimensionally detecting the region (W) by means of active triangulation is formed at least partly in the distal end region, wherein the apparatus for three-dimensionally detecting the region (W) has a projection device (1) for projecting an, in particular coded, color pattern onto the region (W) and a detection device (3) for detecting an image of the color pattern projected onto the region (W), wherein the projection device (1) and the detection device (3) are formed completely or one of the two is formed completely and the other is formed partly in the distal end region in such a way that both have in each case a viewing direction substantially perpendicular to the elongate extent of the angled distal end region, characterized in that the two viewing directions are rotatable about a rotation axis running along the elongate extent of the distal end region, in particular an axis of symmetry of the distal end region.
2. The endoscope as claimed in claim 1, characterized in that a transmission device (5) is designed for transmitting the image generated by the detection device (3) to an evaluation device (7) for processing the image to form three-dimensional object coordinates which can be represented as a 3D image for an operator by means of a display device (11).
3. The endoscope as claimed in any of the preceding claims, characterized in that the endoscope can be angled by approximately 90°
with respect to the regional elongate endoscope extent.
with respect to the regional elongate endoscope extent.
4. The endoscope as claimed in any of the preceding claims, characterized in that a portion of the projection device (1) and of the detection device (3) which is not formed in the distal end region is formed in the longitudinal body adjoining the distal end region.
5. The endoscope as claimed in any of the preceding claims, characterized in that a portion of the projection device (1) and of the detection device (3) which is not formed in the distal end region is formed outside the longitudinal body at a side of a proximal end region of the longitudinal body.
6. The endoscope as claimed in claim 5, characterized in that if the projection device (1) is formed in the distal end region, a light guide device (19) to the projection device (1) is formed from a light source (17) outside the longitudinal body into the longitudinal body.
7. The endoscope as claimed in any of the preceding claims, characterized in that the endoscope is rigid and the distal end region can be angled by means of a joint.
8. The endoscope as claimed in any of the preceding claims, characterized in that the endoscope is flexible and the distal end region can be angled by means of a flexible material or a joint.
9. The endoscope as claimed in any of the preceding claims, characterized in that the endoscope has a mechanical mechanism or electromechanical mechanism by means of which the distal end region can be angled.
10. The endoscope as claimed in any of the preceding claims 2 to 9, characterized in that the transmission device (5) transmits the image by means of at least one transmission medium from the detection device (3) to the evaluation device (7).
11. The endoscope as claimed in claim 10, characterized in that optical or electrical image data are detectable by means of mirrors, electrical lines, light guides or transparent or electrically conductive layers as transmission media.
12. The endoscope as claimed in any of the preceding claims, characterized by a position determining device (9), by means of which a position of the projection device (1) and of the detection device (3) is determinable.
13. The endoscope as claimed in any of the preceding claims, characterized in that the projection device (1) projects white light onto the region (W) of the internal space alternately to the color pattern, and the detection device (3) detects color images of the region (W) alternately to 3D images which are calibratable by means of the white light.
14. The endoscope as claimed in claim 13, characterized in that the display device (11) provides the 3D images and the color images of the region (W) in real time for an operator.
15. The endoscope as claimed in claim 13 or 14, characterized in that the detection data rate of the 3D images and of the color images is in each case between 20 and 40 Hz, in particular 25 Hz.
16. The endoscope as claimed in any of the preceding claims 2 to 15, characterized in that the evaluation device (7) - 24a -fuses three-dimensional object coordinate data of the region (W) with point cloud data of the region (W) obtained by means of at least one further measuring device, in particular a magnetic resonance imaging device or a computed tomography device.
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| DE102013200898.8 | 2013-01-21 | ||
| DE102013200898.8A DE102013200898A1 (en) | 2013-01-21 | 2013-01-21 | Endoscope, especially for minimally invasive surgery |
| PCT/EP2013/075042 WO2014111190A1 (en) | 2013-01-21 | 2013-11-29 | Endoscope, particularly for minimally invasive surgery |
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| EP3316019A4 (en) * | 2015-06-25 | 2019-03-06 | Olympus Corporation | Endoscope device |
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| DK3228254T3 (en) | 2014-02-21 | 2020-03-23 | 3Dintegrated Aps | KEEP INCLUDING A SURGICAL INSTRUMENT |
| DE102015100300A1 (en) * | 2015-01-12 | 2016-01-21 | Carl Zeiss Ag | endoscope system |
| US11020144B2 (en) | 2015-07-21 | 2021-06-01 | 3Dintegrated Aps | Minimally invasive surgery system |
| WO2017012624A1 (en) | 2015-07-21 | 2017-01-26 | 3Dintegrated Aps | Cannula assembly kit, trocar assembly kit, sleeve assembly, minimally invasive surgery system and method therefor |
| DK178899B1 (en) | 2015-10-09 | 2017-05-08 | 3Dintegrated Aps | A depiction system |
| DE102016109173A1 (en) * | 2015-11-19 | 2017-05-24 | Aesculap Ag | Medical-technical coordinate measuring device and medical-technical coordinate measuring method |
| DE102016113000A1 (en) | 2016-07-14 | 2018-01-18 | Aesculap Ag | Endoscopic device and method for endoscopic examination |
| US20180042466A1 (en) * | 2016-08-12 | 2018-02-15 | The Johns Hopkins University | Compact endoscope design for three-dimensional surgical guidance |
| EP3555560B1 (en) * | 2016-12-16 | 2021-09-01 | Universität Basel | Apparatus and method for determining the orientation and position of two rigid bodies |
| WO2019032450A1 (en) * | 2017-08-08 | 2019-02-14 | Intuitive Surgical Operations, Inc. | Systems and methods for rendering alerts in a display of a teleoperational system |
| CN108917667B (en) * | 2018-06-29 | 2020-09-11 | 北京航星机器制造有限公司 | Three-dimensional scanning-based method for measuring inner surface of narrow deep cavity of casting |
| KR102415953B1 (en) * | 2020-10-30 | 2022-07-01 | 재단법인 아산사회복지재단 | Medical endoscope |
| CN113014871B (en) * | 2021-02-20 | 2023-11-10 | 青岛小鸟看看科技有限公司 | Endoscopic image display method and device and endoscopic surgery auxiliary system |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP3316019A4 (en) * | 2015-06-25 | 2019-03-06 | Olympus Corporation | Endoscope device |
| US10742958B2 (en) | 2015-06-25 | 2020-08-11 | Olympus Corporation | Endoscope apparatus |
Also Published As
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| CN105188503A (en) | 2015-12-23 |
| EP2925207A1 (en) | 2015-10-07 |
| DE102013200898A1 (en) | 2014-07-24 |
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| WO2014111190A1 (en) | 2014-07-24 |
| US20150359418A1 (en) | 2015-12-17 |
| CA2898554C (en) | 2018-04-10 |
| KR101799281B1 (en) | 2017-11-20 |
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| CN105188503B (en) | 2017-11-17 |
| JP6129344B2 (en) | 2017-05-17 |
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